Employment Application - Administrative Assistant
Dixie Regional Library System - 111 North Main Street - Pontotoc, Mississippi 38863 www.dixie.lib.ms.us Branches: Bruce - Calhoun City - Houlka - Houston - Okolona - Pontotoc - Sherman - Vardaman
The Dixie Regional Library System is an Equal Employment Opportunity Employer and does not discriminate due to race, color, religion, age, sex, or national origin.
Name
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First Name
Last Name
Physical Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mailing Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
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-
Area Code
Phone Number
Email
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example@example.com
Best time to contact you is:
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Position(s), Type of work applied for
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How did you find out about this opening?
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Are you available to work full time?
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Yes
No
Have you ever been employed with Dixie Regional Library System?
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Yes
No
If yes, give date: (if no, put n/a)
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Have you previously worked for the state of Mississippi, local government, or public school system?
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Yes
No
If so, are you a retiree in the Public Employees' Retirement System of Mississippi (PERS)?
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Yes
No
Not applicable
Are you currently employed?
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Yes
No
Name/Relationship of Friends/Relatives employed here
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Date available for work
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-
Month
-
Day
Year
Date
Desired salary range ($/hr)
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Can you travel if the job requires it? (Limited travel for day long or up to week long training - within Mississippi)
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Yes
No
Driver's License
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In case of accident or emergency, please notify:
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Employment History
Please provide last 3 employers. Put n/a in any fields that don't apply. If need to remove added field, select "Click to remove" by scrolling right.
Professional References - 3 are required (Do not include family, friends, or present or former immediate supervisors) If need to remove added field, select "Click to remove" by scrolling right.
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Start with most recent (scroll to right: multiple columns)
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Education
If not applicable, put "n/a".
High School / GED
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Undergraduate College or University
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Graduate/Professional
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Other
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Do you have any specialized certifications?
Professional Memberships
List all current professional organization memberships below:
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Qualifications
Answer the questions below. Questions with an "MQ" are Minimum Qualifications for this job. Every question with an "MQ" must be answered "YES". If you cannot answer "YES" to every question with an "MQ", you do not qualify for this position. The remaining questions are desirable, but not required, qualifications. It should be noted that those applicants answering "YES" may be considered better qualified for the job. If you answer "YES" to any questions followed by blanks, please give examples of your experience.
MQ Have you had experience using a computer?
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Yes
No
Would you rate your computer skills as:
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Fair
Good
Excellent
Please explain
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MQ Have you had experience using Microsoft Office Applications (specifically Word, Excel, and Outlook)?
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Yes
No
Would you rate your skills as:
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Fair
Good
Excellent
Please explain
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Have you had experience using the Internet and social media?
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Yes
No
If yes, which program(s)/platform(s)?
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Would you rate your skills in this area as:
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Fair
Good
Excellent
Would you rate your knowledge of accounting principles as:
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Fair
Good
Excellent
Please explain
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MQ Have you had experience using QuickBooks Accounting for business/non-profit; specifically Accounts Payable and Payroll?
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Yes
No
If yes, please explain the nature of your experience using QuickBooks?
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Would you rate your skills in this area as:
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Fair
Good
Excellent
Please explain
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MQ Have you had experience in electronic reporting of payroll taxes?
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Yes
No
If yes, please explain the nature of your experience with electronic reporting of payroll taxes?
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Would you rate your skills in this area as:
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Fair
Good
Excellent
Please explain
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Have you had experience submitting PERS (Public Employees’ Retirement System of Mississippi) payments and employer reporting?
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Yes
No
If yes, please explain the nature of your experience with MyPERS?
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Would you rate your skills in this area as:
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Fair
Good
Excellent
Please explain
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MQ Have you had experience with employer administration of State of Mississippi health/life insurance?
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Yes
No
If yes, please explain the nature of your experience with State of Mississippi health/life insurance?
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Would you rate your skills in this area as:
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Fair
Good
Excellent
Please explain
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MQ Have you had experience working with private and confidential documents?
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Yes
No
If yes, please explain the nature of your experience working with private and confidential documents.
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Would you rate your skills in this area as:
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Fair
Good
Excellent
Please explain
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Would you rate your ability to meet deadlines as:
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Fair
Good
Excellent
Please explain
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Do you visit the library:
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Every week
Every month
Several times a year
Other
Do you have any personal obligations which may interfere with your ability to perform the job?
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What do you believe to be your personal strengths and how will they relate to this position?
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What do you believe to be your personal weaknesses and how might they affect your performance?
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By signing or clicking "submit", I certify that the answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in my discharge. I understand, also, that I am required to abide by all rules and regulations/policies and procedures of the library system.
Signature
Date Submitted
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Month
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Day
Year
Date
Submit
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